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Fujimoto D, Shimizu R, Morimoto T, Kato R, Sato Y, Kogo M, Ito J, Teraoka S, Otoshi T, Nagata K, Nakagawa A, Otsuka K, Katakami N, Tomii K. Analysis of advanced lung cancer patients diagnosed following emergency admission. Eur Respir J 2014; 45:1098-107. [PMID: 25323241 DOI: 10.1183/09031936.00068114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Data on prognosis and predictors of overall survival in advanced lung cancer patients diagnosed following emergency admission (DFEA) are currently lacking. We retrospectively analysed data from 771 patients with advanced nonsmall cell lung cancer between April 2004 and April 2012. Of the 771 patients, 103 (13%) were DFEA. DFEA was not an independent predictor of overall survival by multivariate Cox proportional hazard models, whereas good performance status (PS), epidermal growth factor receptor gene mutation, stage IIIB, adenocarcinoma and chemotherapy were independent predictors of overall survival (hazard ratio (95% CI) 0.36 (0.29-0.44), p<0.001; 0.49 (0.38-0.63), p<0.001; 0.64 (0.51-0.80), p<0.001; 0.81 (0.67-0.99), p=0.044; and 0.40 (0.31-0.52), p<0.001, respectively). Good PS just prior to opting for chemotherapy, but not at emergency admission, was a good independent predictor of overall survival in DFEA patients (hazard ratio (95% CI) 0.26 (0.12-0.55); p<0.001). DFEA is relatively common. DFEA and PS at emergency admission were not independent predictors of overall survival, but good PS just prior to opting for chemotherapy was an independent predictor of longer overall survival. Efforts to improve patient PS after admission should be considered vital in such circumstances.
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Affiliation(s)
- Daichi Fujimoto
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryoko Shimizu
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takeshi Morimoto
- Clinical Research Center, Kobe City Medical Center General Hospital, Kobe, Japan Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Ryoji Kato
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuki Sato
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mariko Kogo
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Jiro Ito
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shunsuke Teraoka
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takehiro Otoshi
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazuma Nagata
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Atsushi Nakagawa
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kojiro Otsuka
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Katakami
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Dept of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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